Safety Messages

Lessons From Challenger

 

This Jan. 28, marks the 35th anniversary of the Challenger accident. The loss of the crew was a tragedy felt by their families, friends and coworkers at the agency, as well as people throughout the world.

The Challenger accident taught us tough lessons and brought forward what have become recognizable phrases: normalization of deviance, organizational silence and silent safety program. Sadly, we learned these lessons again in 2003 with the loss of Columbia and her crew. This shows how vital it is that we pause to revisit these lessons and never let them be forgotten. We cannot become complacent. 

In this month's Safety Message, Harmony Myers, director of the NASA Safety Center, discusses the Challenger accident and the lessons it continues to teach us today.

Reminders to Keep You Safe

Welcome to the Office of Safety and Mission Assurance Safety Message archive. This page contains Safety Message presentations and related media. While some of these presentations are not NASA related, all of them have certain aspects that are applicable to NASA. I encourage you to disseminate these to your organizations to promote discussion of these issues and possible solutions.

—W. Russ DeLoach, Chief, Safety and Mission Assurance

Skin Cancer Prevention and Screening

A Life Saving Survey

June 04, 2018

Each year in the U.S., over 5.4 million cases of non-melanoma skin cancer are treated in more than 3.3 million people. There are more new cases of skin cancer than breast, prostate, lung and colon cancer combined. One in five Americans will develop skin cancer over the course of a lifetime. Melanoma, the most lethal form of skin cancer, can develop from less dangerous types of skin cancer. Although simple screening exams can catch this process before it begins, one person dies of melanoma every hour. We are all vulnerable.

As a member of the National Council on Skin Cancer Prevention, NASA has been working to lower these statistics. The first year on the council, NASA was awarded the American Academy of Dermatology's Golden Triangle Award for our agencywide skin cancer prevention efforts.

Please take time to view this message from NASA's Chief Health and Medical Officer Dr. J.D. Polk and remember to set up a screening exam during your next physical. It’s quick and simple and could possibly save your life.

Fatigue and Mishap Risk

March 05, 2018

Does NASA’s culture pay tribute to overwork? A look at the careers of our best-known engineers, scientists and safety specialists can lead to a simple conclusion: long days and nights, accompanied by high stress, lead to high achievement. Successful research and exploration don’t happen without the investment of time and effort.

However, cumulative fatigue is not just unhealthy, it’s unproductive. We behave as if intoxicated, showing impaired judgment and slowed reflexes. No amount of coffee, energy drinks or other stimulants allows us to “power through” the exhaustion.

This month’s Safety Message focuses on the effects of fatigue in the workplace as well as countermeasures to prevent or mitigate those effects. I encourage you to discuss how to combat workplace fatigue with your staff and work to implement smarter scheduling and recognize human limitations.

Apollo1 — Challenger — Columbia Lessons Learned

February 05, 2018

As we continue to apply lessons from the Apollo, Challenger and Columbia mishaps, it's important to recognize that we fell into persistent, systemic behaviors over the decades separating each tragedy.

How do we set precedents today upon which to base better decisions in the months and years to come?

These hard-earned lessons, distilled into rules by Space Shuttle Program Manager Wayne Hale, point us in the right direction moving forward.

Mining the FEVS

January 08, 2018

As many of you have heard me say, I believe that taking care of your people is essential to success. I’ve told the story that in the U.S. Marine Corps, all leaders are asked to do two things: accomplish the mission and take care of your people. Usually, this is followed with “If you do No. 2, your people will take care of No. 1.”

An important part of taking care of your people and accomplishing your mission, is ensuring, throughout your organization, people feel comfortable speaking up, without fear of reprisal. We have seen first-hand the effects fear of reprisal can have on a culture, as it was a theme for both the Challenger and Columbia mishaps, and we need to ensure that we’ve learned from our past and cultivate an environment where speaking up is not just accepted, but applauded.

As we approach the 15-year anniversary of the Columbia accident, I encourage you to review all the data available in the Federal Employee Viewpoint Survey and consider how you can enact positive change at every level in your organization to create an open, safe environment for everyone.

Smoking Is Cool, Right?

October 02, 2017

Even before NACA became NASA, scientists had confirmed and published evidence of the lung cancer risks associated with nicotine in cigarettes. Yet, its powerful, addictive chemistry continues to fuel a multibillion-dollar American habit that costs lives. 

 It is up to each individual: No one else can supply the necessary willpower to quit. Each of us can choose to summon the willpower, or cheer on others, to achieve freedom from the lifeshortening effects of smoking. 

This month, Dr. Vince Michaud refreshes our recollection of the risks while also providing insight into the effectiveness of various approaches to stop smoking. 

Skin Cancer Prevention and Screening

A Life Saving Survey

June 05, 2017

Each year in the U.S., over 5.4 million cases of non-melanoma skin cancer are treated in more than 3.3 million people. There are more new cases of skin cancer than breast, prostate, lung and colon cancer combined. One in five Americans will develop skin cancer over the course of a lifetime. Melanoma, the most lethal form of skin cancer, can develop from less dangerous types of skin cancer. Although simple screening exams can catch this process before it begins, one person dies of melanoma every hour. We are all vulnerable.

As a member of the National Council on Skin Cancer Prevention, NASA has been working to lower these statistics. The first year on the council, NASA was awarded the American Academy of Dermatology's Golden Triangle Award for our agencywide skin cancer prevention efforts.

Please take time to view this message from NASA's Chief Health and Medical Officer Dr. J.D. Polk and remember to set up a screening exam during your next physical. It’s quick and simple and could possibly save your life.

Human Factors and Risk Management

Safety Message

May 01, 2017

Often, when stories of accidents appear in the news, speculation begins that the hapless operator “made a mistake.” With this assumption, many move on, satisfied the cause has been found — operator error.

A surprising number of industry and government safety programs focus on carrot-and-stick efforts to transform people into reliable performers. However, systems thinking tells us that an error is a symptom of a system that needs change. People generally strive to do the right thing and get the task done efficiently; in hindsight, people apply the error label to mishap-related actions and decisions since they have gained precise knowledge of the bad outcome. What was the context for causal actions or decisions — was it unsafe or confusing conditions?

Finding or compensating for errors is just the beginning of pursuing a change. Why did the error occur? Why did the decision seem to be a good idea at the time? Discovering the factors that shape performance and improving the system or interface will reliably reduce safety risk, compared to counseling employees and placing them back into an unsafe system.

The Dangers of Distracted Driving

March 06, 2017

As a society, we have become reliant on technology both at work and at home. Many of us keep our cell phones on-hand around the clock, believing an instantaneous response is not only wanted, but expected from friends, family and colleagues. Although we all feel inclined to meet these social expectations, it’s crucial that we adjust our behavior when driving and put down or turn off our cell phones until we reach our destination.

NASA policy prohibits use of hand-held devices while driving on NASA property or operating a NASA vehicle. In an attempt to honor this policy and be safer drivers in general, we often turn to hands-free devices; however, research shows that hands-free doesn’t mean risk-free.

I urge you to not use your cell phone while driving, even with hands-free technology. That phone call or text message can wait — your life is more important. 

Apollo 1: Lessons and Legacies

February 06, 2017

This year marks the 50th anniversary of the Apollo 1 fire and the tragic loss of Gus Grissom, Ed White and Roger Chaffee.

I strongly believe that we need to regularly look back at our mishaps and revisit their lessons. Your review of the organizational causes that were common in all three of our major mishaps is our best insurance against repeating those painful lessons.

I encourage you to take time, on this anniversary, to remember the lives we lost and recall what we learned as we moved forward with human spaceflight. Using 30 minutes of your next staff meeting or program control board to discuss this would be a fitting tribute to those that literally gave their lives to our nation’s space program.

Lessons Learned From Apollo, Challenger and Columbia

January 09, 2017

As we approach our Day of Remembrance for the Apollo, Challenger and Columbia mishaps, it's important to recognize that we fell into persistent, systemic behaviors over the decades separating each tragedy.

How do we set precedents today upon which to base better decisions in the months and years to come?

These hard-earned lessons, distilled into rules by Space Shuttle Program Manager Wayne Hale, point us in the right direction moving forward.

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